Despite Public Hearing, Va`s Record Not Cleared

THREE HOURS of ``public hearing`` offered by a U.S. House subcommittee on the safety of heart surgery at Miami`s Veterans Administration Medical Center does not amount to a clean bill of health.

In fact, the perfunctory meeting of the House Veterans Affairs subcommittee on hospitals and health care held last week had all the signs of a whitewash:

(BU) No facts of performance were made public.

(BU) Testimony consisted almost totally of mutual, unsubstantiated assurances among VA officials that the Miami heart surgery program had substantially improved.

(BU) Eminent Houston heart surgeon Dr. Michael DeBakey voiced strong support for the Miami program. But DeBakey also said he was ``not sure`` that the VA`s requirement that heart surgery teams perform at least 100 operations a year to ensure proficiency was adequate to ensure patient safety. In earlier statements, DeBakey said he had not visited the Miami hospital and could not comment directly on its program.

(BU) Only Dr. J. Lancelot Lester III offered what appeared to be concrete information that the Miami cardiac surgery program, which he has headed since January 1984, has improved.

Although other VA officials have refused to make public the hospital`s current mortality rate, Lester said 6.6 percent of patients failed to survive heart surgery in the past six months. That death rate is below the 10 percent death rate that the VA considers excessive.

VA officials closed the Miami unit in December after the Fort Lauderdale News and Sun-Sentinel disclosed death rates were more than twice the VA`s national average between 1973 and 1983. The program reopened Feb. 15.

Despite this sham of a public hearing, U.S. Rep. Dan Mica, D-Lake Worth, who requested the hearings said, ``It appears that the quality of care in Miami is as good as it is anywhere.``

If Mica can prove that, he should come forward with the substantiated facts.

The Miami VA cardiac surgery program may have substantially improved in 1984. We have Lester`s word for it. But because of a 1980 law that says all reports dealing with the quality of VA medical care are confidential, there is nothing to back up Lester`s statement.

What is most frightening is that the 1973-1983 record of Miami is not an isolated case. Through the Freedom of Information Act, the newspaper has acquired more government documents showing that five VA hospitals reported excessive heart surgery deaths in 1984 ranging from 12 to 23 percent -- death rates higher than that which prompted the Miami closing.

The House Veterans Affairs subcommittee on hospitals and health care did not do a credible job last week. And the VA -- the largest single health care provider in the nation -- still is able to function behind closed doors.